FORM 4 Cupertino Rotary Endowment Foundation
Legacy Society Membership Form
Day Phone Evening Phone
Birth Date (optional) Email
I have made a legacy gift to Cupertino Rotary Endowment Foundation as indicated below:
o Will (Please designate: Cupertino Rotary Endowment Foundation)
o Life Insurance Policy or Retirement Plan Beneficiary Designation
o Trust in which Cupertino Rotary Endowment Foundation is named as a beneficiary. Please indicate
when the Foundation’s interest will take effect. (Example: “Income to my spouse, then principal to
Cupertino Rotary Endowment Foundation”)
o Deferred Gift ) i.e. Charitable Gift Annuity, Pooled Income Fund, Charitable Remainder Trust,
Charitable Lead Trust, etc. Contact the current CREF President to discuss.
o Other (please describe)
Estimated amount of gift (optional): $ or % of estate, policy or account
Optional: Please enclose a copy of the pertinent section of your document mentioning Cupertino Rotary
Endowment Foundation as a beneficiary. We will retain this in our confidential files as a record of your
Congratulations. Your gift qualifies you for membership in our Legacy Society. We are honored to
recognize you in our Legacy Society materials unless you indicate otherwise.
o Please list my/our names as follows:
o I/we wish to remain anonymous
o Please have someone call me about my estate plans and how I might include CREF.
Name Signature Date